Treatment of femoral condyle fractures after total knee arthroplasty：report of 12 cases

SONG Jin-hui; ZHANG Er-yang; ZHANG Chen; WANG Kun-zheng

doi:10.3969/j.issn.2095-252X.2016.10.005

Abstract：Objective To analyze the causes of femoral condyle fractures after total knee arthroplasty and investigate the preventive measures and treatment methods.Methods The clinical follow-up data of 12 patients who had femoral condyle fractures after total knee arthroplasty from July 2013 to August 2015 were analyzed retrospectively, including 5 males and 7 females. According to Rorabeck classiifcation, there were 9 cases of IIA type, 1 case of IIB type and 2 cases of III type. All the 9 patients ( IIA type ) were treated with internal ifxation in 2 weeks after admission. A patient ( IIB type ) underwent conservative treatment with skeletal traction, and plaster external ifxation was applied 4 weeks later. Knee revision surgery was performed on the 2 patients ( III type ).Results All the patients were followed up for an average of 28.9 months ( range: 17 - 34 months ). Bone healing was achieved in 10 cases at 3 months after the surgery. Delayed union occurred in 2 cases, and bone healing was achieved at 6 months and 11 months after the surgery respectively. The average time of bone healing was 4.2 months in all the cases. During the follow-up, there was no internal ifxation failure, infection, prosthetic loosening or obvious pain. Knee lfexion-extension function was good, and the active degree was 90° - 120° at the final follow-up. At 3 months after the surgery, the average hospital for special surgery ( HSS ) score was ( 81.3 ± 6.3 ) points, and at the ifnal follow-up the average HSS score was ( 94.9 ± 3.7 ) points.Conclusions All these factors should be considered in the treatment of femoral condyle fractures after total knee arthroplasty, such as prosthetic loosening, fracture site and type, patients’ physiological condition and so on. A further study should be carried out for a standard treatment option.